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California birth defects monitoring program

(Cbdmp)

Birth Defects Prevention Month January 2019

January 2019 is Birth Defects Prevention Month and this year’s theme is “Best for You. Best for Baby”.
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The California Birth Defects Monitoring Program (CBDMP) would like to take this opportunity to increase awareness of birth defects, the leading cause of infant mortality in the United States.  This year's goal is to promote healthy choices to help lower the risk of having a baby born with a birth defect. That means every woman age 15-44 years should be taking steps to prevent birth defects before even thinking about becoming pregnant.

There are many different kinds of birth defects including congenital heart defects, cleft lip or palate, defects of the brain and spine, and a variety of genetic conditions such as Down syndrome. Some have only a minor and brief effect on a baby's health and some have life-threatening and life-long effects. 

We know that not all birth defects can be prevented. However, we encourage women to make healthy choices and adopt healthy habits to help lower their risk of having a baby born with a birth defect. Women who are already pregnant or think that they could be pregnant should start prenatal care right away. It is important to see your healthcare provider early and regularly throughout pregnancy.  

Practicing the following five tips and sharing them with friends and family is a great start for promoting ways to reduce the chance that a child will be born with a birth defect.

Tip 1: Be sure to take 400 micrograms (mcg) of folic acid every day.

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Our bodies use folic acid, a type of vitamin B, to make new cells.  Folic acid taken before pregnancy can help prevent some birth defects in the baby's brain and spine.

Folate is found naturally in certain fruits, vegetables, and nuts. Folic acid is found in fortified foods (labeled "enriched foods"), such as breads, pastas, and cereals. In addition to eating foods with folate from a varied diet (such as spinach and avocado), you can:

  • Take a vitamin that has folic acid in it every day.
    • Vitamins can be found at most local pharmacies and grocery stores. Check the label on the bottle to be sure it contains 100% of the daily value (DV) of folic acid, which is 400 mcg.
    • Most vitamins sold in the United States have the recommended amount of folic acid women need each day
  • Eat fortified foods.
    • You can find folic acid in some breads, pasta, breakfast cereals, and corn masa flour.
    • Be sure to check the nutrition facts label and look for one that has “100%” next to folate.

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Tip 2: Talk with your healthcare provider before stopping or starting any medicine.

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Many women need to take medicine for medical conditions. If you are trying to have a baby or are just thinking about it, now is a great time to start getting ready for pregnancy by talking with your doctor about medications you may be taking or about any other steps you can take to be as healthy as possible before becoming pregnant. 

Understanding how medicines can impact a developing baby is not easy. This means there may not be easy answers about possible risks for some medicines when used in pregnancy. If you are planning to become pregnant, discuss your current medicines with your healthcare providers, such as your doctor or pharmacist. There are often benefits to continuing your treatment throughout your pregnancy. However, if you and your healthcare provider decide to change your medicines, discussing a treatment plan before a pregnancy can give you time to consider all options that can help keep you and your developing baby as healthy as possible.

Planning how to take care of your health conditions before you become pregnant can help keep you and your developing baby healthy. Don't forget to talk about your family history when visiting your healthcare provider! Based on your family history, your doctor might alter your care or refer you for genetic or nutritional counseling.

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Tip 3: Become up-to-date with all vaccines, including the flu shot.

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Vaccines help protect you and your baby. Some vaccinations, such as the flu (influenza) vaccine and the Tdap vaccine (adult tetanus, diphtheria, and acellular pertussis vaccine), are specifically recommended during each pregnancy. 

Having the right vaccinations at the right time can help keep you and your baby healthy. Get a flu shot and Tdap vaccine during each pregnancy to help protect yourself and your baby.

Flu: You can get the flu shot before or during each pregnancy. Pregnant women with flu have an increased risk of serious problems for their pregnancy, including preterm birth. Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy has been shown to protect both mom and baby (for up to 6 months after delivery) from the flu.

Tdap: You should get the Tdap vaccine near the end of each pregnancy (weeks 27 – 36).  After getting the shot, your body will make protective antibodies (proteins made by the body to fight off diseases) and will pass some of the antibodies to your baby before birth. These antibodies give your baby some short-term protection against whooping cough (also called pertussis). These antibodies can also protect your baby from some of the more serious complications of whooping cough. If you live in the home or will be helping to take care of a new baby, you should also receive the Tdap vaccine before the baby is born.

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Tip 4: Before you get pregnant, try to reach a healthy weight.

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Obesity has been shown to increase the risk for several serious birth defects, such as omphalocele and certain heart defects, and can also contribute to other pregnancy complications, such as diabetes and increased risk for C-section. If you are underweight, overweight, or obese, talk with your healthcare provider about ways to reach and maintain a healthy weight before you get pregnant. Eating healthy foods and being physically active are great ways to prepare for pregnancy. If you are overweight, dropping just 5-10% of your weight can have a major impact on your health and reduce your risk for complications in pregnancy.

One size does not fit all. During pregnancy, follow the guidelines for weight gain that match your weight before pregnancy. Talk to your healthcare provider about making physical activity a part of healthy pregnancy.

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Tip 5: Boost your health by avoiding harmful substances during pregnancy, such as alcohol, tobacco, and other drugs. 

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Alcohol: There is no known safe amount of alcohol during pregnancy or when trying to get pregnant. A developing baby is exposed to the same concentration of alcohol as the mother during pregnancy. This can result in a range of lifelong physical, behavioral, and intellectual disabilities to the baby. In addition, alcohol may make it harder for a woman to become pregnant. Alcohol use in pregnancy can also increase the risk of miscarriage, stillbirth, prematurity, and sudden infant death syndrome (SIDS). 

Alcohol can have negative effects on a baby's development at any time during pregnancy, including very early in pregnancy before a woman even knows she is pregnant. That is why it is important to stop drinking alcohol when you start trying to get pregnant. If you are a heavy drinker, you may need medical care to help you to stop drinking in a safe way.

Tobacco: Today, tobacco can be consumed in multiple ways; this includes traditional forms like cigarettes, cigars, pipes, chew, snuff, and hookah as well as newer forms like e-cigarettes/vapes.

Smoking causes cancer, heart disease, and other major health problems. Smoking during pregnancy can harm the placenta and a developing baby and can cause certain birth defects. The placenta grows in your uterus (womb) and supplies the baby with food and oxygen through the umbilical cord. Cigarette smoke has over 4,000 chemicals. When you smoke during pregnancy, chemicals like nicotine, carbon monoxide and tar damage the placenta and/or pass through the placenta and umbilical cord to reach your baby's bloodstream. Quitting smoking will help you feel better and provide a healthier environment for your baby.

Because they are relatively new and are not well-regulated, there is less known about the effects of e-cigarettes on pregnancy. Until more and better information is available, it is recommended that pregnant women not use e-cigarettes.

Marijuana: During pregnancy, the chemicals in marijuana (in particular, tetrahydrocannabinol or THC) pass through mom to a developing baby, and could harm a baby's development.  More research is needed to better understand how marijuana may affect mom and baby during pregnancy, therefore it is recommended that pregnant women not use marijuana. There is some research of possible harm, so why take the risk?

Prescription Opioids: Painkillers such as codeine, morphine, and oxycodone may be prescribed following an injury, surgery, or dental work. Any type of opioid exposure during pregnancy can cause neonatal abstinence syndrome, or a condition the newborn experiences from withdrawing from certain drugs following exposure during pregnancy. If you are pregnant and taking an opioid, talk to your doctor before making any changes. Ask about options for opioid treatment to decide what's best for you and your pregnancy.

Other Drugs: Using certain drugs during pregnancy can cause health problems for a woman and her developing baby. If you are pregnant or trying to get pregnant and can't stop using drugs―please ask for help! A healthcare provider can help you with counseling, treatment, and other support services.

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Join the effort to increase awareness of birth defects and the impact they have on all of us. Below are a collection of materials that you may view and share with others.

Social Media

The California Department of Public Health (CDPH) will be tweeting regularly throughout the month of January highlighting the importance of folic acid and increasing birth defects awareness.

Prevention Materials

Plan ahead, avoid harmful substances, choose a healthy lifestyle and talk to your healthcare provider. Making a plan to get healthy before and during pregnancy can help you have a healthy baby.

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